Accuracy of modified 30-s chair-stand test for predicting falls in older adults

Abstract

Postural stability during sit-to-stand (STS) movements depends on visual and somatosensory information. A modification of the 30-sec chair-stand test (30s-CST) with visual and somatosensory alteration (m30CST) may improve the ability to identify fall status. This study aimed to investigate the accuracy of the m30CST in predicting falls in older adults. This prospective cohort study recruited a convenience sample of 73 individuals from Kao Kilo community, Chonburi, Thailand. Eligibility criteria were age≥65 years and independent STS ability. All participants performed the 30s-CST and m30CSTs (i.e., eyes closed and a foam surface and eyes closed and a foam surface). The fall incidence during a 6-month follow-up was recorded. The area under the receiver operating characteristic curve (AUC) was calculated. Twenty participants were designated for reliability and validity analyses using the 30s-CST and the Fullerton Advanced Balance (FAB) Scale, estimating intraclass correlation coefficients (ICCs). We included 37 fallers and 36 non-fallers. All tests showed excellent accuracy in classifying fallers (AUC=0.77-0.91). The m30CST with eyes closed and a foam surface had the highest AUC (0.91), with a cutoff score of 9.25 repetitions, sensitivity 92%, and specificity 81%. The m30CSTs presented excellent inter-rater reliability (ICC=0.93-0.96) and test-retest reliability (ICC=0.90-0.96), good to excellent correlation with the 30s-CST (r=0.90-0.98), and moderate to good correlation with the FAB Scale (r=0.64-0.73). The m30CST could be used as an alternative evaluation for predicting the risk of falls in community-dwelling older adults, with excellent accuracy.